The Politics of Public Health and Private Medicine
Like the Greek mythology mentioned above, the curative and preventive models ofhealth care have competed for preeminence in the American health care system. Since the second half of the twentieth century the curative model has dominated the American health care system while public health has often suffered a great deal of neglect. Even though the schism between public health and private medicine did not develop until the beginning of the twentieth century, two different approaches to explaining the human body were expressed centuries aga by Rene Descartes and Baruch Spinoza. Descartes viewed the human body as a self-contained, material machine. The Cartesian approach tried to explain how the human body works as an intricate machine, what causes it to malfunction, and what can be done to repair it. Spinoza in contrast, relying on Jewish tradition, espoused a more rational view that regards the human body as a complex and spiritual being, and the human body can be understood only in relation to unities larger than itself, that is, the whole of nature (Barglow 2002). Medicine in the sixteenth and seventeenth centuries, rather than taking a more integrative approach between these two approaches, adopted the Cartesian model. Today, more than four centuries later, the contradictions between these two approaches still remain unresolved (Barglow 2002).